Time is running out! We need your help!

We are running out of time, but you can make a difference! Please call Rep. Smithee's Austin office (512-463-0702) and say"Please ask Rep. Smithee to schedule a public hearing for HB 2946 relating to group health benefit plan coverage for loss or impairment of speech, language, or hearing." It really is that easy! Help us move this bill forward!

Waiting...

I am not one that waits very patiently; I want to make something happen, but right now we are waiting to see if/when Representative Smithee will schedule a hearing for HB 2946. Representative Coleman has to ask for the hearing since he is the one that sponsored the bill. I have been in touch with his office and this is in the works. We  just have to wait to see when/if the hearing is scheduled. I asked if there was any order or rhyme or reason as to when/how the hearings were scheduled and I was told no, it is just up to the chair of the committee.

What you can do:

• Call Representative Smithee's office (512-463-0702) and ask that he please schedule a hearing for HB 2946 before the House Insurance Committee.
• Watch for updates and be ready to go to Austin and attend the hearing if/when it is set.

Text of HB 2946

Below is the text of HB 2946. Anything underlined is a proposed addition to the existing statute, which is the rest of the non-underlined text. For a printable version, go to the HB 2946 page on the Texas Legislature's website.

82R11984 TRH-F

By:  Coleman                                     H.B. No. 2946

A BILL TO BE ENTITLED

AN ACT

relating to group health benefit plan coverage for loss or impairment of speech, language, or hearing.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1.  The heading to Chapter 1365, Insurance Code, is amended to read as follows:

CHAPTER 1365.  LOSS OR IMPAIRMENT OF SPEECH, LANGUAGE, OR HEARING

SECTION 2.  Section 1365.003, Insurance Code, is amended by amending Subsection (a) and adding Subsection (c) to read as follows:

(a)  A group health benefit plan issuer shall offer and make available under the plan coverage for the necessary care and treatment of loss or impairment of speech, language, or hearing for a covered individual, including a person covered as a dependent under the plan.

(c)  A coverage or premium quotation for the purchase or renewal of a group contract must include an offer of coverage described by Subsection (a).

SECTION 3.  Chapter 1365, Insurance Code, is amended by adding Section 1365.005 to read as follows:

Sec. 1365.005.  COVERAGE REQUIRED.  (a)  A group health benefit plan issuer shall provide coverage under the plan for the necessary care and treatment of loss or impairment of speech, language, or hearing for a person covered as a dependent child under the plan.

(b)  Coverage required under this section:

(1)  may not be less favorable than coverage for a physical illness under the plan; and

(2)  must be subject to the same durational limits, dollar limits, deductibles, and coinsurance factors as coverage for a physical illness under the plan.

SECTION 4.  This Act applies only to an insurance policy that is delivered, issued for delivery, or renewed on or after January 1, 2012.  A policy delivered, issued for delivery, or renewed before January 1, 2012, is governed by the law as it existed immediately before the effective date of this Act, and that law is continued in effect for that purpose.

SECTION 5.  This Act takes effect September 1, 2011.

HB 2946 has been assigned to the Insurance Committee

Yesterday, the bill was read and assigned to the House Insurance Committee. The next step will depend on the chair of the insurance committee, Representative John Smithee, scheduling a hearing for the bill before the committee. Representative Coleman will request the hearing but we can help by calling Rep. Smithee's office (512-463-0702) and asking that he schedule a hearing as well.

Once we have a hearing date, we will need folks willing to go to Austin. If you might be interested in testifying, or if you know someone who has a convincing personal story about the need for insurance coverage for the treatment of speech, language, and hearing impairment, please contact me. Even if you do not want to speak, it is important to have people there in support of this bill. You can come and sign in on a piece of paper registering you support and you never have to say anything; this does make a difference! I am planning on taking my children since this legislation includes a mandate of coverage for dependents - let the representatives look in the faces of the children this bill would affect. Let's pack the hearing and show them that Texans think this issue is important!

In the blue bar at the top of the page, there is a link to "Follow" this blog. Click on that to receive notification of new posts.

We have a Bill!! HB 2946 has been filed!

WHOOHOO!! Representative Garnet Coleman has filed our bill! You can follow the progress, read the text (as soon as it is posted), and sign up for alerts on the bill's progress here:
http://www.legis.state.tx.us/BillLookup/History.aspx?LegSess=82R&Bill=HB2946

A huge THANK YOU to Zena Wommack and Representative Kelly Hancock for helping get this far! His office had it drafted and  Ms. Wommack sent the draft over to Representative Garnet Coleman's office so they could file it.

We still have a lot of work to do to make this happen so stay tuned! I will be calling on everyone to make calls, write letters, send emails, and maybe even testify when the time comes!

Filing deadline is Friday!

Well, we still don't have a correct draft back yet. I did get a draft a week ago, but it did not say what we really wanted it to, so we are still waiting. I did go to Austin this past Thursday and spent all day at the capitol talking with staff at different offices of 16 different representatives and senators. I am hopeful that we will be able to get something filed before Friday. Did I mention the filing deadline is FRIDAY? Yes, day after tomorrow?

I will say that every office I visited was very friendly, willing to listen and did take my information and promised to consider the request; even those legislators I know are not friendly to issues like "insurance mandates". You have to understand that those two little words are like foul language to many law makers. It doesn't matter what the coverage is for, they feel that the free market system should be allowed to let employers decide for themselves what coverage they choose and what they pay for - period. The only problem with this model is when you have a low incidence issue like hearing loss, there is not enough market demand to influence coverage and those like my family are left with tough decisions on how to provide treatment our children desperately need but we just cannot afford. I should also add that the ones most often affected are those like us that are working and have some type of private insurance, and we often make too much to qualify for assistance programs; however, we do not make enough to pay out $6,000-$12,000 out of pocket for hearing aids and all that accompanies them (and that's just for one person, remember our family has THREE hearing aid wearers!).

Back to my trip to Austin: I am very grateful for all of the staff that took the time to meet with me. I learned quite a bit about the process and several gave me great advice on how to continue to work on this issue. I do feel we have a chance with a couple of the offices to possibly get a least a version of our draft filed by Friday.

Just as a side note, on my visit to the capitol building, I also learned that the House chambers do not currently have accommodations for people with hearing loss to follow the happenings on the floor. The gallery clearly falls under the guidelines in the ADA and Texas Accessibility Standards which require assisted listening devices or other appropriate accommodations, so I was a bit flabbergasted. After speaking with several different people in different locations in the capitol, I did talk with David Sauceda, the Assistant Sergeant at Arms for the Texas House of Representatives, and he has followed up on my inquiry. An email I received from his yesterday says they are working on a check-out system in order for the public to access the ALD's they have for use by the Representatives and press. He said they have never had anyone from the public ask before.

Who have we talked to so far?

This is our current progress. So far I have contacted the following Texas congressional offices about possibly sponsoring the bill:

Declined:
Representative Kelly Hancock (but he did have his office submit it for drafting so that was a huge help!)
Representative Tracy King
Representative Vicki Truitt (updated 2/28/11)
Senator Jane Nelson (updated 3/1/11)

Contacted, still waiting to hear back*:
Representative Garnet Coleman
Representative Todd Smith
Representative Senfronia Thompson
Representative Eddie Lucio III
representative Larry Taylor

*If you one of the above congress persons represents you, please consider calling their Austin office and asking that they support Texans with speech hearing and language needs by filing this bill for us!

To find out who represents you and their contact information, go to http://www.fyi.legis.state.tx.us/.

If your representatives are not on the list and you are willing to contact their offices about filing this bill, leave a comment with what district you are in and I will contact you!

Thanks for the support!

The Proposal

For the proposal to make sense, a little background on the current law is helpful.

Current law: The current insurance code in Texas requires that group insurance companies offer purchasers (i.e. employers) the option of purchasing speech and hearing coverage. There is no requirement as to when the employer is notified of this coverage or that they be told how much it would cost. The employer has the option of not accepting the coverage or, if they choose to add any coverage for speech and/or hearing services, to negotiate any level of coverage they wish. This assumes that the benefits representative for the employer even realizes that the offer of coverage, which is typically buried in the final paperwork, is even available or that these services are not already covered under a typical policy. This negotiation takes place between the employer and the insurance company; the employee is never offered the option of coverage if the employer chooses not to elect coverage for speech and hearing benefits, and the vast majority of employers do not offer this coverage, even though the change in premiums is minimal.

Proposal Summary: The proposed bill has two parts. This bill would:

• Require insurance companies to notify group plan purchasers (employers) of the offer of coverage at the time of initial quotes and bid the policy with the speech, language and hearing coverage included as an option. This would allow employers the ability to make a more informed choice as to what benefits they wish to provide for their employees. This provision, if passed as written, would apply to covered individuals over the age of 18.
• Require insurance coverage for minors under the age of 18, or those over the age of 18 if eligible as a dependent. The coverage under this provision for speech, language and hearing services would be provided at the same rates as other illness covered under the policy.

Here is the actual text as it was submitted for drafting. PLEASE NOTE: THIS IS NOT THE FINAL BILL. I will post that as soon as the draft is available. (Original statue is in normal text, amendments are underlines, deletions are a strike through.):

A BILL TO BE ENTITLED

AN ACT

relating to group health benefit plan coverage for speech, language, or hearing impairments.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. Section 1365.003, Insurance Code, is amended to read as follows:

Sec. 1365.003. OFFER OF COVERAGE REQUIRED. (a) A group health benefit plan issuer shall offer and make available under the plan coverage for the necessary care and treatment of loss or impairment of speech, language, or hearing for those above the age of 18 and who are not otherwise eligible as a dependent.

(b) Coverage required under this section:

(1) may not be less favorable than coverage for physical illness generally under the plan; and

(2) must be subject to the same durational limits, dollar limits, deductibles, and coinsurance factors as coverage for physical illness generally under the plan.

(c) Offer of coverage shall be included in all information and quotes offered to group contract holder.

Sec. 1365.004. RIGHT TO REJECT COVERAGE OR SELECT ALTERNATIVE BENEFITS. An offer of coverage required under Section 1365.003 is subject to the right of the group contract holder to reject the coverage or to select an alternative level of benefits that is offered by or negotiated with the group health benefit plan issuer.

Sec. 1365.005. COVERAGE REQUIRED. (a) A group health benefit plan issuer shall provide coverage for the necessary care and treatment of loss or impairment of speech, language, or hearing for those below the age of 18, or above the age of 18 if eligible as a dependent.

(b) Coverage required under this section:

(1) may not be less favorable than coverage for physical illness generally under the plan; and

(2) must be subject to the same durational limits, dollar limits, deductibles, and coinsurance factors as coverage for physical illness generally under the plan.

SECTION 2. This Act applies only to an insurance policy or contract or evidence of coverage that is delivered, issued for delivery, or renewed on or after January 1, 2012. An insurance policy or contract or evidence of coverage delivered, issued for delivery, or renewed before January 1, 2012, is governed by the law as it existed immediately before the effective date of this Act, and that law is continued in effect for that purpose.

SECTION 3. This Act takes effect September 1, 2011.

Drafting!!

Our proposal has been submitted to the Texas Legislative Council for DRAFTING into a possible bill! Thank you to Representative Kelly Hancock's office for submitting this for us. I knew of the filing deadline (March 11) but I had not heard of the internal drafting deadline before speaking with Rep. Hancock's District Director - which was Friday, Feb. 18 - the same day I met with her at 3:00 p.m. Since it was so close to the deadline, the fact that Rep. Hancock's office submitted this for us is huge; otherwise we would be looking at a two year wait to try again. He did decline to sponsor the bill due to his already full plate of insurance commitments, but I appreciate the support he did give us in filing!

So now we have until March 11 to find a sponsor to file the drafted bill for us. We do not have time to wait until the draft comes back so I am using the proposal as submitted to approach potential sponsors. If you are interested in asking your representative to sponsor a bill, please let me know. I can send you all the information you will need, I just need people willing to make a phone call! It is very easy!

My phone calls have sounded something like this:
Me: Hi! My name is (Tamara Joyce-Wylie) and I am a constituent in Rep. (Name)'s district. I was hoping that he/she would be interested in filing a bill relating to insurance coverage for speech, language and hearing coverage on behalf of families like ours that are affected by (hearing loss). (Short personal application: I weare hearing aids and so do my two young daughters; this legislation would help our family tremendously.)
Aid: (Usually asks for name and address and if I have more information on the proposed bill).
Me: The bill has been submitted for drafting and I would be happy to email you the proposal.
Aid: That would be great, my email is name@house.state.tx.us.
Me: Thank you! I will email you the information as soon as possible.
Aid: I will forward it to the representative/his legislative director and contact you after they have reviewed it.

That's it! I can give you an email mail with all the information you need to submitt and you can ask that the representative's office contact me if they have further questions (if you are not comfortable answering them). Please let me know if you are willing to do this!!

Who is TXSICHA?

This is grass-roots at its finest. I started this blog but I hope someday to include a long list of people and organizations when the question "Who is TXSICHA?" comes up in the future. Will you join us and be a part of it?

My name is Tamara Joyce-Wylie. I am a hearing aid wearing mom of 4, the youngest 2 of whom also wear hearing aids. My dad wears hearing aids that he got as hand-me-downs when mine were replaced due to a need for more power. I doubt he ever would have spent the money to purchase them on his own. I am a voter, I am a constituent, I am a consumer who pays what seems like an exorbitant amount for insurance with no guarantee it will cover the largest annual expenditure for medical needs our family has - hearing related expenses. And I decided it was time to do something about it!

I began loosing my hearing in my early 30's after the birth of my first child. As first I was told that hearing aids would not help, and I went several years descending into a world that was becoming more and more quiet, thinking all the time there was nothing to be done to help me. About two years after my initial dismal experience with a hearing professional, I had returned to college and decided to get another opinion from the audiology program clinic on campus since it was free to students. At that time, I was told that hearing aids would help with my moderate-to-severe loss and that it would cost about $4,000, oh, and by the way, insurance didn't cover them.

As a single mother going to college and working part time, there was no way I was going to be able to afford hearing aids. Again, I went through the process of learning to accept living in a quiet world, only this time it was more difficult, knowing there was help available, I just couldn't afford it.

At the time, I was working part time in my father's small real estate development company and his few employees were covered under a group insurance plan. Part of my responsibilities included handling the insurance. When we were going through the renewal process and I was signing off on all the final paperwork, I noticed a page that had several optional riders listed and places for me to sign that we were offered but declined that coverage. One of those riders was for speech and hearing coverage. I immediately picked up the phone and called our insurance office and asked about the rider. She at first told me we didn't need any of those and to just sign the paper. Instead I insisted that she find out if this would cover hearing aids and if it did, how much it would cost. She called back shortly with the information and a new quote - yes the rider would cover hearing aids and the increase in our monthly premiums would be $7 for the company! A tiny amount for coverage I desperately needed. The rider was added to our policy, and I was finally able to get the hearing aids I had done without for years.

While they aren't perfect and my hearing was still not that great, my hearing aids completely changed my life. I did not realize how much I was missing until the aids helped me hear again. I had been slipping into depression, cutting myself off from social activities because the effort to communicate was just too hard. My hearing aids gave me the confidence to try again.

Fast forward three years to when my two young daughters were both diagnosed with hearing loss with in weeks of each other. Suddenly we needed four more aids, in addition to the recommendation that my aids be replaced with more powerful models sue to a decrease in my won hearing. The girls were 7 months and 3 years old at the time of their diagnosis; within that narrow window of opportunity for the best speech and language development. Clear access to language is critical for a child's educational success and quality of life. I was so thankful that I had already been down this road with our insurance company and we had coverage in place to provide aids for the girls.

Unfortunately most people in Texas do not have that same opportunity for coverage. most group insurance companies do not choose the rider and do not offer coverage for hearing aids. In addition to the aids, there is the cost of audiological evaluations and ear molds. In a young child who is growing fast, ear molds may need to be replaced as often as every 2-3 months. For adults with hearing loss, being able to access communication in a meeting, on the phone, with customers, may mean the difference between being able to work and loosing a job, not to mention the psychological and relational impact hearing loss has on a person's quality of life. But more about the benefits of hearing aids later. I just wanted to introduce myself.

If you have a story about how hearing aids have helped you/your child or how the cost or insurance has affected your ability to purchase hearing aids, please send me an email. With your permission, I may include it in he blog.

Spread the word, join the fight, let's make this happen!